Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Updated: Feb 19 2020

Testicular Tumors

5.0

  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon

(1)

Images
https://upload.medbullets.com/topic/116050/images/seminoma_of_the_testis.jpg
  • Introduction
    • Testicular tumors can be of germ cell or non-germ cell origin
      • germ cell origin
        • are the majority (95%) and are more commonly malignant
      • non-germ cell origin
        • usually benign
    • Epidemiology
      • incidence
        • most common cancer in men between 15-35 years
      • risk factors
        • cryptorchidism
        • Klinefelter syndrome
        • testicular feminization
  • Classification
    • Germ cell types
      • seminoma
        • malignant
        • most common testicular tumor
        • mostly affecting males 15-35 years
        • commonly metastasizes to para-aortic lymph nodes before hematogenous spread
      • embryonal carcinoma
        • malignant
        • commonly metastasizes early
      • yolk sac (endodermal sinus) tumor
        • seen in children < 4 years
      • choriocarcinoma
        • malignant
      • teratoma
        • mature teratoma in males is most often malignant
          • unlike females
    • Non-germ cell types
      • Leydig cell (sex-cord stromal)
      • Sertoli cell (sex-cord stromal)
      • Testicular lymphoma
        • most common testicular cancer in older men
        • involves both testes
  • Presentation
    • Symptoms
      • painless unilateral enlargement of testes
      • seminoma
        • homogenous testicular enlargement
      • embryonal carcinoma
        • painful
      • choriocarcinoma
        • gynecomastia
          • due to hCG production which is an LH analogue
      • Leydig cell
        • usually androgen producing
          • gynecomastia in men
          • precocious puberty in boys
    • Physical exam
      • solid mass of the testes is always cancer
  • Evaluation
    • Histology
      • seminoma
        • large cells in lobules with watery cytoplasm
        • "fried egg"
          • analogous to dysgerminoma of the ovary
      • embryonal carcinoma
        • glandular/papillary
      • yolk sac (endodermal sinus) tumor
        • yellow, mucinous
        • Schiller-Duval bodies resemble primitive glomeruli
      • choriocarcinoma
        • disordered syncytiotrophoblastic and cytotrophoblastic elements
      • teratoma
        • contain three tissue types
      • leydig cell
        • contains Reinke crystals
        • golden brown color
    • Serology
      • LDH
        • non-specific
      • specific tumor markers
        • embryonal carcinoma
          • ↑ AFP and hCG
        • yolk sac (endodermal sinus) tumor
          • ↑ AFP
        • choriocarcinoma
          • ↑ hCG
  • Treatment
    • Pharmacologic & radiation
      • radiation therapy
        • indications
          • seminoma is radiosensitive
    • Surgical
  • Prognosis
    • Seminoma
      • late metastasis and excellent prognosis
    • Embryonal
      • worse prognosis than seminoma
    • Choriocarcinoma
      • worst prognosis
        • in contrast to good prognosis in females
        • metastasizes to lungs
Card
1 of 0
Question
1 of 3
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options